- Health Care Service Corporation (Tulsa, OK)
- …the Autism Spectrum Diagnoses (ASD). JOB REQUIREMENTS: Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, BCBA, ... This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical necessity… more
- Saint Francis Health System (Tulsa, OK)
- …matching the level of care utilization . Assures compliance with Managed Care Behavioral Health standards in the area of UM procedures and documentation to ... therefrom or Master's degree in Social Work, Counseling or related behavioral health field. Licensure, Registration and/or Certification: Valid multi-state… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Medical Director for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring they meet the ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Medical Director for further review. The reviewer independently applies medical and behavioral health guidelines to authorize services, ensuring they meet the ... managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover… more
- AmeriHealth Caritas (Newtown Square, PA)
- …managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover ... standards based on DHS/NCQA requirements. Education/Experience: Bachelor's Degree required. Professional licensure in health care or social services-related… more
- PeaceHealth (Eugene, OR)
- …collective bargaining agreement, seniority, etc. Responsible for identifying potential behavioral health inpatient unit candidates, pre-screening referrals, and ... Description PeaceHealth is seeking a RN Admissions Coordinator/ Utilization Review - Psychiatric Unit for a Per...preparing patients for admission to Behavioral Health Inpatient Unit, including patient consultation.… more
- Highmark Health (Little Rock, AR)
- …This role supports the full application product lifecycle for clinical and utilization management software , with a specific focus on driving key technical ... They function as a pivotal bridge, translating high-level clinical and utilization management software business needs into detailed technical requirements for new… more
- Commonwealth Care Alliance (Boston, MA)
- 011230 CA-Provider Engagement & Performance Position Summary The Behavioral Health (BH) Provider Engagement Program Manager is responsible for cultivating ... strong, collaborative relationships with behavioral health providers and driving performance improvement through data insights, education, and partnership. This… more
- Banner Health (Gilbert, AZ)
- …familiarity with Alzheimer's disease and developmental disabilities. Employees working at Banner Behavioral Health Hospital, BTMC Behavioral , and BUMG, ... ensure smooth and efficient patient care management and resource utilization . Leads change by developing, implementing and evaluating quality...BUMCT, or BUMCS in a Behavioral Health clinical setting that serves children must possess an… more
- WellSpan Health (Chambersburg, PA)
- …providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. ... effectively manager cost and maximize employee satisfaction and resource utilization . Duties and Responsibilities Essential Functions: Facilitates and directs… more
